The Economics of Health Care Along the U.S.-Mexico Border: Recent Trends and National Policies

Michael G. Ellis

Abstract

Two vastly different health care systems confront one another along the 2000 miles of U.S.-Mexico border. In large measure the economies of those two systems determine the nature of health care provided in the border region. This a rticle examines the health care sector in the U.S. and Mexico as each responds to economic forces, and describe the resulting hybrid health care system that has evolved in the border region in the context of recent economic trends and national policies.

Since disease vectors pay no heed to the arbitrary demarcation known as the international border, these two often antagonistic health care systems share a common patient population as it moves primarily northward. The human drama played out each day along the border, is influenced by economic imperatives whose signatures are indelibly etched in the form and substance of each country's health care establishment. The Mexican economy is seriously imperiled. It's commitment to the health of its population manifests ominous signs of disregard brought about by the emaciated state of the national economy. Northward migration is seen as a "safety valve" for the jobless and sometimes the sick and the outlook for the future promises little improvement. The U.S. on the other hand is laboring under a sluggish national economy and a myopic preoccupation with the size of its federal deficit. The current trend is to shift responsibilities for social expenditures from the Federal Government to the state and local ones. This then, is a recipe for disaster in the U.S.-Mexico border health field. One country is involved in an economic struggle on the order of life itself, unable to care for its population, confronting another nation, economically mature, but one which chooses to turn away from its national responsibilities for health care at the border. This article suggests that a continuation of current economic trends and national policies in the U.S. and Mexico has the potential to create a health care crisis in the border region.